“Ever had a beef about a hospital or a long-term care facility? Who hasn't?
Whether you feel you were badly treated at a hospital, or know someone who died of a hospital-acquired infection, or have a relative living in unspeakable conditions in a long-term care home, no doubt you've asked yourself at some point: Who holds these places accountable?
If you live in any province but Ontario, you can ultimately turn to your ombudsman for help with your problem.
As I will do today when I release my annual report, the ombudsman can shine a spotlight on festering issues in the public sector, and recommend workable solutions. My office helps thousands of people every year with their individual problems with government, and our systemic investigations have sparked the province to improve its programs for millions.
But no such luck if your complaint is about a hospital. There's no chance of an independent, impartial investigation or much hope of a resolution – unless you are determined and rich enough to go to court. Hospitals and long-term care facilities are among the privileged few public agencies to live in a zone of immunity, largely unaccountable and unanswerable to the outside world – even though they receive some $18 billion in government funds each year.
Why has the government resisted calls to open up hospitals and long-term care to independent oversight – calls that go back 33 years, to the very first ombudsman? Certainly not because all is well. On the contrary, the government is so concerned about hospital mismanagement and substandard service that it has taken over an unprecedented number of hospitals this past year. From 2002 through 2006, the province assumed control of just four hospitals. But in 2007 alone, it took over four, and a fifth in early 2008.
Now it is grappling with the stunning revelations of patient deaths from C. difficile infections in our hospitals – some 260 in just seven hospitals since 2006. By all accounts, C. difficile infection is horrific. It affects the most frail and vulnerable, robs them of dignity and isolates them from their families. As more and more Ontarians demand answers about the superbug, there have been threats of group lawsuits and calls for a public inquiry.
In my view, the C. difficile issue is tailor-made for an ombudsman investigation – it's a complex systemic issue that should be looked at impartially and efficiently. Indeed, Quebec's ombudsman, who has had the power to investigate hospitals for a few years now, has helped families of patients get more information about the superbug, and one of her investigations resulted in the creation of a special hospital team for maintaining sanitary conditions in C. difficile patient rooms.
Here in Ontario, the health minister has said he doesn't see the benefit in handing this or other hospital-related issues to "someone whose skills are outside of the medical arena." That's understandable. It's also a common misconception about the way my office works.
I freely admit my staff and I aren't medical experts. But we are experts in independent, impartial investigations. We have years of experience in probing sensitive, high-profile administrative issues, and completing our work quickly and cost-effectively. We are experts in analyzing complaints, rooting out the administrative problems behind them and recommending ways to ensure they don't recur.
When we investigated "insider" wins at the Ontario Lottery and Gaming Corp., the "experts" at the top levels of the corporation told us it would be impossible to get players to sign their tickets, much less register retailers or subject them to background checks. Today, a year after our investigation, the OLG is doing all that and more.
When we investigated the province's newborn screening program in 2005, the "medical experts" were doing just two tests for treatable disorders – meaning some 50 babies per year were dying or left severely disabled, unnecessarily. Though the government sounded defensive when we first began our investigation, things changed for the better when we published our findings and recommendations.
Refreshingly, both the premier and health minister committed to transform the newborn screening program from the "worst to the first." Now Ontario screens for 29 disorders, saving and improving the lives of hundreds of children. It was investigative know-how, not medical expertise, that cracked that case.
I'm often asked, if you could investigate complaints about hospitals, what would you do? We'd do the same things we do for people who complain about the 500-odd other government organizations we oversee. Most of the time we resolve issues informally, helping people navigate through bureaucracy. In other cases, we uncover truly unjust, unreasonable situations and recommend fixes. Our recommendations have been overwhelmingly accepted and appreciated by the government because, in the end, they improve public services.
We received 276 complaints this past year about hospitals and long-term care facilities. A change in my mandate would do more than simply give these people somewhere to turn for help. Ombudsman oversight can also act as an early warning system, identifying problems in institutions before they explode, and it can motivate organizations to respond to public concerns more effectively.
With C. difficile having resulted in six times more deaths than SARS — and counting – we need to have all our warning systems on alert. That includes bringing the ombudsman's office to the front lines of the battle.”
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What is the Liberal gang at Queen’s Park hiding?
Why is the McGuinty gang at Queen’s Park afraid of having their oh-so-vaunted health-scare system’s hospitals subjected to external, independent scrutiny?
Where’s the transparency? Where's the accountability?
Ontario Liberal Health Minister George Smitherman himself said several years ago he had little idea of where his multi-billion-dollar hospital budget - our tax money - was going: “We don’t even actually know exactly what we’re buying”, Smitherman told Osprey News”. (St. Catharines Standard, Aug.8, 2005) (see:Liberal Healthcare Duplicity, An Ontario Overview 2003-2007 )
When I contacted my Liberal MPP, St. Catharines Liberal MP Jim Bradley (see: Liberals ignore call for health-monopoly investigation , see: Medicare's secretive death rates and Liberal unaccountability ) about having the Ombudsman investigate Ontario’s Liberal government-run monopoly, Jim Bradley didn’t bother to respond. This smug and arrogant Liberal cabinet minister simply ran away from the concerns brought to his attention.
This is indicative of the smug and arrogant mentality of McGuinty's Liberal government. This is a sign of a dangerously dogmatic majority government which has now circled its wagons to deflect any un-wanted and un-controlled scrutiny of the policies emanating from their Star Chamber. Cabinet ministers refuse to even discuss the problems in their health system - a no-choice system we are forced by Liberal law to financially support, but cannot question.
A Nov. 2007 CIHI study found that the hospital in St. Catharines (in Liberal Jim Bradley's own riding!) had one of the highest patient mortality rates in Canada; when contacted, Liberal Jim Bradley couldn't be bothered to respond. (see: Hospital death-rate in Liberal Jim Bradley's St. Catharines: third-worst in Canada)
Since Nov. 2007, no one from the Liberal government has yet explained the high death-rate found in St. Catharines, in the Niagara Health System. 190 patients have also had their surgeries inexplicably cancelled; and patient-stacking in emergency rooms continues, with patients waiting up to three days (St. Catharines Standard, Jun.10, 2008) on stretchers in the ER before they can actually get a bed. This is not quite the sepia-toned health-care Utopia painted by Michael Sicko Moore, is it?
The Liberal's handling of the C. diff outbreak was a bungled fiasco.
Let's recall how outraged Ontarians - especially smug Liberals - were about Walkerton: six times more people have died in this outbreak, and the Liberals just fumbled their way through it: when a massive C. diff outbreak hit Quebec first, the Liberals in Ontario had plenty of warning; plenty of time, to prepare for the worst.
What, if anything, did they do? How will we ever know?
There's no way this smug and arrogant Liberal government will tell us anything but their version of events.
Even hospital officials are disputing that they didn't know the extent of the outbreak!!
The Hamilton Spectator (Jun.6, 2008) wrote that Don Scott, CEO of Burlington's Joeseph Brant Hospital, "said no information on how to deal with C. diff or what to look out for ever trickled down to his hospital. He doesn't recall a letter that was sent by the Ontario Hospital Association warning hospital CEOs that C. diff was out there.
Scott's comments are contrary to Health Minister George Smitherman's claims that information existed to inform hospitals and the public about risks, including the coroner's review from Sault Ste. Marie, where 26 died in an outbreak in 2006. "
Contrary to Smitherman's claims!?!
And no investigation?!? That is unbelievable.
The story of Burlington's hospital problems are similar to those in St. Catharines - systemic problems. CEO Scott says the hospital is underfunded and needs $300 million in renovations: "We have a hospital here that has totally inadequate facilities. There's people's garages that are in better shape than our operating rooms. They're terrible. We don't have private rooms to accommodate people. We're isolating patients right now so we have 10 rooms that are out of service because of isolation of people. That's 10 more people backed up in emergency department who can't get in. We have 45 people here today who should be in a long-term care facility. That would get our emergency department empty but there's nowhere for them to go."
Let's remember: during the 2007 election the Liberals white-washed and shrugged off suggestions that there were any inadequacies or problems in their glorious government-run health Utopia. Did the Liberal government do all it could to warn hospitals - and warn single-payer-monopoly-trapped patients as well - of the imminent danger of C. diff? Or were the Liberals trying to downplay - if not cover up - the extent and potential danger of the outbreak which occurred on their watch?
Well, certainly the Liberals won't tell us.
Furthermore, they have the privilege of not having to tell us. Liberal politicians such as Jim Bradley can just ignore your questions.
They are deathly afraid that shining a light on how they run Ontario's health-care monopoly could expose their incompetence.
There are way too many unanswered questions at every level of Ontario's health monopoly.
A stale Smitherman should resign as health minister.
The Ombudsman should be able to investigate the Liberal government's (mis)management of Ontario's health monopoly.
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